H2 NATURAL SCIENCE. Feb., 



Roux, Martin, and Chaillou report from the Hopital des Enfants 

 Malades in Paris 300 cases treated with antitoxin, with a fatality of 

 26 per cent., the previous fatality having been 50 per cent. From 

 Berlin, Dr. Baginsky reports 525 antitoxin cases with a fatality of 

 15*6 per cent., the previous fatality having been 41 per cent. Some 

 of the most striking illustrations of the value of the antitoxin treat- 

 ment are to be found in instances where the supply of serum has 

 suddenly failed. At the St. Joseph Kinderspital in Vienna the 

 average diphtheria fatality for ten years had been 51*1 per cent. : on 

 the introduction of the serum treatment 27 cases were treated, with 

 a fatality of 22-6 per cent. The supply of serum failed, and 32 cases 

 had to be treated without antitoxin, and they showed a fatality of 

 65-6 per cent. When the supply was re-established the fatality in 

 21 cases fell to 19 per cent. Similarly at the Leopoldstiidter Kinder- 

 spital in Vienna, the fatality, which had been 26*6 per cent, with 

 antitoxin, rose at once to 66-7 per cent, when the supply of serum 

 failed. The same happened to Baginsky in Berlin : his fatality rose 

 from 15 per cent, to 51 per cent., when in August and September of 

 1894 tne supply of serum failed. 



Welch presents a summary of 82 reports on the antitoxin treat- 

 ment of diphtheria up to July, 1895 5 tne tota l number of cases, 

 from all over the world, treated with antitoxin, amounts to 7,166, with 

 an average fatality of 17-3 per cent., and these are nearly all hospital 

 cases, and the great bulk from children's hospitals. He further tabu- 

 lates 38 reports, containing 1,167 cases of laryngeal diphtheria, in 

 which tracheotomy or intubation was required : the fatality in these 

 under antitoxin treatment was 37-2 per cent., a very great improve- 

 ment on previous figures, which showed in most instances a fatality of 

 50 to 80 per cent, in these cases. 



It will be seen from the above statistics, which have been selected 

 as giving a fair average of the results of serum therapeutics in 

 diphtheria, that, in this disease at least, the method is passing out of 

 the stage of trial into one of assured success. A reduction of fatality 

 by something like 50 per cent, would mean the saving of not far short 

 of a thousand lives yearly in London alone. And these would be 

 young lives, since the improvement is shown to be mainly manifest in 

 the earlier years of life. Nor is the statistical evidence the only 

 evidence that can be adduced in favour of the new treatment ; the 

 general impression left on the minds of those who have employed it is 

 strongly in its favour in nearly every instance, and the clinical impres- 

 sions of physicians of large experience and known ability must be 

 allowed great weight. 



In the immunising power of antitoxic serum we have also a pro- 

 phylactic of the highest value. It may be employed in the case of 

 those children or other members of a household who have been exposed 

 to infection. Dr. Hermann Biggs records from New York no less 

 than four instances in which the prevalence of diphtheria in large 



